December 11, 2024
It was 2:45 in the morning when my phone lit up on the table beside me. I was sitting quietly in a dimly lit hospital room, my camera in my lap, documenting a stillbirth for another family. The mother I was with had gone into diabetic ketoacidosis, the same complication that took Cambria from Makayla and Alex the year before, and her baby had passed away before taking their first breath.
I reached for my phone and saw Makayla’s name. The time struck me because it was Landon’s birthday. Her message came quickly. She had been admitted to UF Shands Hospital in Gainesville. Her blood sugar was over 300. The doctors were talking about keeping her for a day or two to stabilize her before starting an induction. She apologized for bothering me on this day.
I told her there was nothing to apologize for. She could never be a bother to me, no matter the date or the hour. Birth does not wait for convenient moments, and neither would I. I asked her to keep me posted as things unfolded so I could be ready to leave the moment she needed me.
She explained that the doctors wanted to keep her at Shands for a day or two to get her blood sugar under control before starting the induction. It was not what she had been expecting, but they were already talking about the possibility of meeting her baby much sooner than she had planned. We went over what that might look like, and I assured her I would be ready whenever the time came.
I resumed supporting the family who was saying goodbye to their baby in the room with me. I checked my phone often, keeping in touch with Makayla as her plans shifted. I stayed until that family was ready for some privacy, leaving the Advent Health Ocala hospital just after 11 a.m.
Shortly after, Makayla shared what was weighing on her heart most. She had expected to have another week of slow mornings with Cassia before the baby arrived, and now she would not get that time.
I reminded her to breathe deeply, to ask every question she needed to, to make the choices that felt right for her and her baby. I reminded her that Cassia would forgive the change quickly once she met her best friend.
Not long after, she told me they were going to induce that day. I smiled and texted her, “It is a beautiful day to have a baby.”
We talked about the possibilities. Babies born at thirty six weeks sometimes go straight to their parents’ arms, and sometimes they need a little help in the NICU. Either way, she was in the best hands at Shands. She ate, gathered herself, and was moved to labor and delivery to prepare for her induction.
Since they were not planning to begin the induction until later that evening, I decided to head home for a bit. I told her I would try to take a short nap so I could be rested and ready for the hours ahead. I reminded her that if she wanted me there sooner, all she had to do was send a message or give me a call and I would come right away. She told me to rest while I had the chance. So I went home, set my bag by the door, and curled onto my side in bed. My own rainbow baby shifted and kicked at twenty one weeks, a quiet reminder of how precious and fragile this work can be. Rainbow babies do not erase the storm that came before them, but they carry a light that can make the darkness feel softer. I thought about how Makayla’s heart must have been holding so many feelings at once, grief for what she had lost, love for what she had now, and hope for the moment she would finally hold her baby in her arms. I wished for her strength through every wave, for calm in the quiet moments, and for her to feel surrounded by love with every step. More than anything, I hoped the hours ahead would bring her the safe and joyful ending she had been dreaming of for so long.
Later in the afternoon, I sent Makayla a quick message to check in and see how things were going. She replied almost right away, telling me her nurse’s name, and my heart lifted when I realized it was my dear friend, Allie. Just knowing she was there made me feel a wave of relief. Allie has a way of making every patient feel seen, heard, and cared for, and I knew Makayla was in good, compassionate hands.
Makayla told me that the team had placed a Foley bulb, a small balloon gently inserted inside the cervix to help it open to around three or four centimeters, and that she had been given a dose of misoprostol, a medication used to soften and ripen the cervix so labor could begin to build. These steps meant things were finally moving forward, the first real signs that the long wait for her baby’s arrival was starting to come to an end.
It felt like a good time to join them since rush hour had just ended. To step into their space and begin documenting the next chapter of their story. I gathered my bag, checked my gear, and headed straight to UF Shands to join Makayla and Alex, ready for whatever the hours ahead might hold.
When I stepped into the room, Makayla and Alex were in good spirits. We hugged, chatted, and caught up while she worked through early contractions. Makayla had taken the time to freshen up and put on a little makeup, a small act of control and normalcy before things became more intense. She moved between the birth ball and standing, rocking gently as Alex and I took turns offering counter pressure on her lower back.
Not long after I arrived, the Foley bulb slipped out while she was laboring on the toilet, what I lovingly call the dilation station. We all laughed at how silly it looked dangling there, and Alex even held it up for a few lighthearted photos. In the middle of this long and uncertain day, it felt good to hear genuine laughter in the room.
Even as we laughed, I noticed the memorial pillow tucked into the corner of the bed. Cambria’s detailed face on a pillow shaped just like her with the same darling green floral blanket she was wrapped in during her time earthside, a quiet reminder of the little girl who should have been here too. Her presence in the room was felt in every pause, in every deep breath Makayla took, and in the way Alex’s eyes softened when he looked at his wife.
Allie eventually headed home for the evening and the night shift nurse took over. Pitocin was started, a synthetic form of oxytocin used to strengthen and regulate contractions, and Makayla’s blood sugar was checked regularly to keep her safe. We snacked, we talked, and as the hours went by, the contractions began to demand more of her. Alex and I alternated between hip squeezes and counter pressure, helping her move through positions like hands and knees, standing, leaning on the bed, and back to the ball.
When the intensity became too much, Makayla decided to try nitrous oxide, or laughing gas, a mask she could hold over her face to breathe in a mix that can take the sharp edge off each contraction. She did beautifully with it for nearly an hour, but Pitocin contractions are relentless, and eventually she decided an epidural would give her the rest she needed to keep going. As the anesthesiologist worked, I thought about how birth, especially after loss, is never just physical. It is the mental push to keep moving forward when your body and your heart are exhausted. It is choosing to believe that this time will be different, that this time you will walk out with your baby in your arms.
The room grew quieter after the epidural was placed. The lights were dim, the beeping of the monitors steady and constant. Makayla’s body finally had the chance to rest. I watched her shoulders relax into the bed, her face softening as the tension eased away for the first time in hours. Alex sat beside her, his hand resting gently on hers, the two of them sinking into this fragile pocket of calm together.
December 12th, 2024
Slowly, through the night, she made progress. But by morning, her baby was still high. Each time the nurse came to check her, we hoped to hear the words “your baby has moved down,” yet the numbers stayed the same. Her fingers were sore from being poked for blood sugar checks every hour, the bruises a quiet testament to how much her body was enduring.
Makayla’s contraction pattern was strong and steady, and her baby was tolerating the induction well, but progress was painfully slow. We began cycling through position changes: flying cowgirl, side-lying leg releases, the Miles Circuit. We used a peanut ball to open her pelvis and help her baby rotate. Alex and I worked together to “shake the apple tree,” a gentle but vigorous movement of her hips meant to help bring the baby into a better position. We tried forward-leaning inversions on the CUB, each adjustment made with hope that this would be the one that made a difference.
Makayla had polyhydramnios, an excess of amniotic fluid, which made it harder for the baby to settle low into her pelvis. It was another layer of challenge in a birth that already carried the weight of so many emotions. This was the same hospital where she had said goodbye to Cambria. Now she was here again, her rainbow baby’s heartbeat filling the room where once there had been silence.
Laboring after loss is a constant push and pull between past and present. Every contraction brings you closer to meeting the baby you’ve been dreaming of, yet each moment also carries echoes of the one you lost. There is hope and fear intertwined. There is the memory of what went wrong, and the quiet courage it takes to believe that this time will end differently.
Around early afternoon, a midwife and OB came in to discuss breaking her water. They explained the risks and benefits, and after some thought, Makayla agreed. When her water was released, a rush of fluid spilled across the bed. The pressure from the polyhydramnios was finally gone, and she sighed in relief, feeling lighter instantly. The OB then suggested placing internal monitors to better track both the baby’s heart rate and her contractions. I explained what each device would do and what it would mean for her mobility. Makayla was tired and worn down, but she nodded her consent. I leaned in and told her she was doing beautifully and that soon she would have her baby in her arms.
Through it all, the small memorial pillow stayed tucked against the side of the bed. Every time my eyes caught it, I felt the truth of why this birth was so powerful. Cambria’s story was woven into every moment here. Her absence was part of the weight Makayla was carrying, but her love was part of the strength that kept her going.
Eventually, the time came to push. The room shifted in energy. The lights grew brighter, the birth cart was rolled in, and the team gathered quietly around her bed. Makayla took a deep breath, her hands gripping the sides of the bed, and began to work with every ounce of strength she had left.
She pushed on her side, then switched to tug-of-war with a sheet, bracing her feet and pulling hard with each contraction. She changed to the other side, then tried a more upright position, each time giving everything she had. I encouraged her through every set, Alex holding her hand and whispering to her, his eyes never leaving hers. Holding her through every wave, through every push.
I had a feeling that her baby might be in the occiput posterior position (OP), where the back of the baby’s head faces the mother’s spine instead of her belly. It is a position that often makes pushing longer and more intense. The molding on her baby’s head when it finally began to crown confirmed it. This was not an easy feat, yet Makayla never backed down.
Minutes blurred into over an hour, maybe closer to two. The effort was relentless. Her breathing grew heavier, her voice broke a few times, and still she kept going. I thought about the strength it takes to labor after loss, and how that strength was showing in every push. She was not just pushing against the resistance of her baby’s position, she was pushing through fear, through memories, through the echoes of the day she had said goodbye to Cambria in this same hospital.
Finally, after one more long, determined push, her baby slipped into the world and straight into her arms. The cry came instantly, strong and sure, and the sound cracked the tension in the room wide open. Tears fell freely, from Alex, from me, from anyone who had witnessed the weight of this journey.
A baby girl. Freya. Born at 4:15 in the afternoon, warm and breathing and safe in her mother’s embrace.
Makayla and Alex held her close, their tears falling into her dark hair. They chose delayed cord clamping, waiting until the cord turned white and limp before Alex cut it. Makayla delivered her placenta and nestled Freya to her chest, studying her perfect features with the look only a parent who has known loss can give. It is a look that says, “I will not take a single second of this for granted.”
I stood back for a moment, letting them take it in. Freya’s arrival was more than just the birth of a baby. It was a victory over the weight of fear. It was the continuation of a love story that began with Cambria and now carried forward in her little sister. It was the proof that although rainbow babies do not erase the storm, they bring light through it.
They called Alex’s parents first, surprising them completely. They had not even known a new grandbaby was coming, and their joy was audible even through the speaker. Makayla called her mom next, asking her to guess the baby’s gender before revealing she had another granddaughter. When it was time to tell Cassia, her voice lifted with excitement as she told her big sister that her long-awaited best friend was finally here. She giggled and squealed with delight on the video call.
As I packed my gear and prepared to leave, I took one last look at Makayla and Alex with their newborn daughter. The weight of the past and the joy of the present both filled the room, existing together in a way that only parents who have known loss can truly understand. Freya was sleeping soundly against her mother’s chest, the rhythm of her tiny breaths a sound that would forever be cherished.
I thought back to the morning I met Cambria, the quiet in that hospital room, the sacred way Makayla and Alex held her, memorizing every detail of their first and last hours with her. That day had been heavy with grief, but it was also filled with love. Today, in the same hospital, I had watched those same parents welcome another daughter, their arms finally full, their hearts still carrying the one who could not stay.
This is why I do what I do. Birth photography is not just about documenting a moment, it is about holding space for the entire story. It is about honoring the children who came before, the ones who are here, and the ones who are still to come. It is about standing beside families in their brightest hours and in their darkest, and making sure that every chapter, no matter how joyful or heartbreaking, is remembered.
When I stepped outside, it was well past dark. The air was cool and still, the hospital parking lot quiet except for the soft hum of streetlights. In that moment, I thought about how love can hold both joy and sorrow in the same breath. Families like Makayla and Alex’s show us the courage it takes to keep going. Freya’s story will always carry Cambria’s name in its beginning, and I know without a doubt that her big sister was there that day, watching over her, proud of the family who will speak her name for the rest of their lives.
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